Makino K, Amatsu M, Kinishi M, Mohri M
Department of Otolaryngology, Kobe University School of Medicine, Japan.
Arch Otorhinolaryngol. 1988;245(4):224-9. doi: 10.1007/BF00463932.
Myringitis granulosa is not a rare pathologic condition of the tympanic membrane. However, the condition can be misdiagnosed as chronic suppurative otitis media, since intermittent purulent discharge is the commonest symptom in both disorders. Although the clinical features of myringitis granulosa have been well described by several authors, its pathogenesis is still obscure. In this study, 40 cases of myringitis granulosa were examined in detail to clarify the clinical features and the pathogenesis present. No drum perforations, no hearing impairments and normal X-ray findings indicated that myringitis granulosa had no relation to chronic suppurative otitis media. The other areas of the affected tympanic membrane, except for the site of granulation, showed such pathologic conditions as atrophy, clouding and calcifications. In these pathologic tympanic membranes, epithelial migration was disturbed to a high degree. We suggest that the granulation process on the tympanic membrane should be divided into two stages: (1) injury reaching the lamina propria of the tympanic membrane; and (2) disturbed epithelization of the tympanic membrane. The disturbance of epithelial migration of the tympanic membrane occurs with both stages.
颗粒性鼓膜炎并非鼓膜罕见的病理状况。然而，该病症可能会被误诊为慢性化脓性中耳炎，因为间歇性脓性分泌物是这两种病症最常见的症状。尽管已有数位作者对颗粒性鼓膜炎的临床特征进行了详尽描述，但其发病机制仍不明确。在本研究中，对40例颗粒性鼓膜炎患者进行了详细检查，以阐明其临床特征及发病机制。无鼓膜穿孔、无听力障碍且X线检查结果正常，表明颗粒性鼓膜炎与慢性化脓性中耳炎无关。除肉芽部位外，鼓膜其他受累区域呈现出萎缩、浑浊及钙化等病理状况。在这些病理性鼓膜中，上皮迁移受到高度干扰。我们认为鼓膜上的肉芽形成过程应分为两个阶段：（1）损伤累及鼓膜固有层；（2）鼓膜上皮化受到干扰。鼓膜上皮迁移的干扰在这两个阶段均会发生。
